OBJECTIVE: The cyclic variation of physical and psychological phenomena has been accepted as a natural consequence of the cyclicity of the human female reproductive function. The exact nature of these changes, however, has not been fully understood. The aim of our study was to investigate the fluctuation of psychological and physical symptoms throughout the female reproductive cycle in healthy, non-PMDD women.

METHOD: 63 psychiatrically healthy, non-PMDD women with normal regular menstrual cycles and not using hormonal contraceptive methods participated in the study. Participants completed the PRISM calendar every night for three consecutive cycles and on three predefined days of the first cycle they completed several other psychometric measures (SCL-51, STAI, ZSDS, EAT and Mind and Body Cathexis Scale). Based on an at least 66% increase in physical symptoms from the late follicular to the late luteal phase on the PRISM, subjects were assigned to LPPS (luteal phase physical symptoms) and nonLPPS (no luteal phase physical symptoms) groups. Average of psychometric scores obtained at the three predefined days were compared between the two groups.

RESULTS: There was a significant difference between the two groups only in case of the interpersonal sensitivity subscale of the SCL-51.

CONCLUSION: Our results indicate that the appearance of severe physical symptoms in the late luteal phase of the female reproductive cycle is not accompanied by a worsening of psychological symptoms. The appearance of enhanced psychological symptomatology attributed to the luteal phase of the female reproductive cycle thus seems to be independent of the appearance of severe physical symptoms.

Keywords: reproductive cycle, depression, anxiety, premenstrual syndrome

The ventral tegmental area (VTA), the prefrontal cortex and the nucleus accumbens (NAc) are key elements of the mesolimbic dopaminergic system. Dopaminergic neurotransmission in the NAc is essential in the regulation of motor activity and reward. Extracellular ATP by activating P2 receptors may function as a neurotransmitter or a neuromodulator. We showed that P2 receptors are expressed both in the NAc and VTA, and their activation (probably of the P2Y1 subtype) results in increased dopamine release. It leads to complex neurophysiologic and behavioral changes. We observed activation of the EEG: an elevation of the absolute EEG power and the power in the alpha-frequency band as well as decrease in the delta-frequency band. Behavioral studies demonstrated that activation of P2 receptors elicited more consistent and stronger goal-directed locomotor activity in response to the stimulus of a novel environment. P2Y receptors were also involved in regulation of feeding, their inhibition decreased the amount and the duration of feeding. On the other hand, in various behavioral functions, P2 receptor-mediated glutamate release or the activation of the adenosine receptors counterbalanced the actions mediated by ATP-induced dopamine release. We also showed that enhancement of the P2Y1 receptor expression may be involved in adaptive changes of the mesolimbic system such as behavioral sensitization to repeated amphetamine administration. In summary, the mesolimbic dopaminergic system is modulated via P2Y purinergic receptors, and it may lead to complex behavioral pharmacological changes.

Keywords: neuromodulation, dopaminergic, purinergic, mesolimbic, behavior